Finding ‘3rd generation’ crucial in contact tracing, says Magalong

MANILA, Philippines — Following the entry of the UK variant of the coronavirus in the country, local governments must step up their own contact tracing without relying on the national government, according to Baguio City Mayor Benjamin Magalong, who is in charge of the national contact tracing effort.

The first case of the more contagious UK variant of the virus that causes COVID-19, a severe respiratory disease, was a Filipino male resident of Quezon City who returned from a trip to Dubai in the United Arab Emirates (UAE) on Jan. 13.

Magalong on Saturday said the country’s contact tracing efficiency ratio was just 1:7 to 1:9, far from the ideal 1:37, or 37 contacts of up to three generations, or layers of possible transmission, per infected person.

The first generation refers to the close contacts of the index case, or the original infection. The close contacts of the first generation comprise the second generation, whose contacts are classified as the third generation.

Magalong said mayors should motivate their contact tracers to seek out the third generation contacts by going beyond the first and second generations to attain the ideal ratio. He stressed that finding third generation contacts should be part of standard operating procedures.

Among the challenges in achieving this “ideal ratio” is the smaller number of contact tracers since most had their contracts terminated on Dec. 31, 2020, due to budget constraints, Magalong said.

The discovery of the more transmissible UK variant in the country also poses an added challenge as this necessitates intensified contact tracing efforts, he said.

“Local governments must really make the move. They should not simply rely on the Department of Health or the Philippine National Police,” Magalong said at the Laging Handa briefing.

“Local governments should take the lead in contact tracing. Mayors must be directly involved so that they could maintain their contact tracing efficiency ratio,” he said.

MONITORING TOOL Caloocan City has been using QR-coded quarantine bands since September last year to monitor residents who have tested positive for the coronavirus. —GRIG C. MONTEGRANDE

DILG challenge

Undersecretary Jonathan Malaya, spokesperson for the Department of the Interior and Local Government (DILG), said in a statement on Saturday that only a third of the 50,000 contact tracers employed last year would be rehired in 2021.

He said the DILG would have to work “with the available budget” allocated for contact tracing to continue the service.

“Hence, only 15,000 CTs (contact tracers) will be rehired under a six-month contract in the meantime while we wait for the release of additional funds,” Malaya said.

The Department of Budget and Management allocated P1.9 billion for the hiring of contact tracers in 2021. Of this amount, P500 million is included in the 2021 national budget, and P1.4 billion is from the unreleased balance under Republic Act No. 11519, or the Bayanihan to Recover as One Act.

Need for motivation

Malaya said the DILG field offices and local government units were directed to immediately assess the performance of the contact tracers and select those “who have effectively and efficiently performed their assigned tasks” for rehiring.

The DOH earlier said contact tracing efforts would be expanded to include third-generation contacts of the patient found with the UK variant of COVID-19.

Also on Saturday, the DOH reported 2,058 new cases, pushing the country’s total COVID-19 caseload close to the half-million mark with 498,691 cases.

It reported 406 recoveries, raising the total number of survivors to 460,133. With eight new deaths, the death toll rose to 9,884.

The deaths and recoveries left 28,674 active cases. Majority, or 84.7 percent of them were mild, 7.7 percent asymptomatic, 4.6 percent critical, 2.6 percent severe and 0.14 percent moderate.

In Quezon City, Mayor Joy Belmonte said local authorities traced 143 individuals linked to the man infected with the UK variant. They include those who had close contact with him and their contacts, plus the health workers and eight other passengers on the plane with him who were also from Quezon City and who are now in quarantine.

She said they were still looking for one of these passengers.

The city also tested the man’s family members even though he had not interacted with them upon his arrival. His girlfriend who traveled with him was reswabbed, Belmonte said. The results of all their tests are being awaited, she said.

The good news, Belmonte said, was that the man was asymptomatic and was not even hospitalized.

“The patient is actually doing quite well,” she reported during Saturday’s Laging Handa briefing. “He is just waiting to complete his antibiotics and for his doctor to declare that he is well.”

Mood in Kamuning

According to Belmonte, this shows that while the UK variant was more transmissible, it does not necessarily cause more severe symptoms.

She also tried to ease the anxiety of residents in the Kamuning neighborhood where the man lived, saying he was not even able to step into his home as he was immediately quarantined in a hotel after he tested positive for coronavirus shortly after his arrival from Dubai.

Kamuning residents had panicked and were discriminated against after his address was made public. Some residents were told not to report for work even though the patient had not interacted with them, Belmonte said.

Some people also refused to visit markets and grocery stores in Kamuning, she added.

Rehiring quotas

In a memorandum earlier this week, DILG Officer in Charge Bernardo Florece Jr. directed regional offices “to prioritize the rehiring of contact tracers” in localities with “active cases and have rising active cases.”

The most number of contact tracers to be rehired will be from the National Capital Region (2,381), Region 3 (1,504) and Region 7 (1,417) based on a prorated quota, according to Malaya.

He said the quota was based on the number of active cases in a particular region and the 30 percent across the board distribution of the 15,000 contact tracers to be rehired for 2021.

The DILG plans to rehire 1,264 contact tracers in Calabarzon; 1,052 in Region 9; 974 in Region 6; 813 in Region 11; 856 in Region 5; 634 in Region 10; 510 in the Bangsamoro Autonomous Region in Muslim Mindanao; and 501 in Region 1.

Another 451 contact tracers will be hired in Mimaropa; 433 in Region 8; 352 in Region 2; and 267 in the Cordillera Administrative Region.

—With reports from Dexter Cabalza and Patricia Denise M. Chiu